Figure 1. Flowchart of SPRINT and ACCORD Eligibility Criteria Applied to Adult NHANES Participants.

ACC/AHA indicates American College of Cardiology/American Heart Association; ACCORD, Action to Control Cardiovascular Risk in Diabetes trial; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); BP, blood pressure; DBP, diastolic blood pressure; HDL, high-density lipoprotein cholesterol; LDL, low-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate; NHANES, National Health and Nutrition Examination Survey; SBP, systolic blood pressure; SPRINT, Systolic Blood Pressure Intervention Trial; ULN, upper limit of normal.

SI conversion factors: To convert HDL and LDL to mmol/L, divide by 0.0259; creatinine to µmol/L, multiply by 88.4.

Trial eligibility was determined in NHANES participants without and with diabetes using the published inclusion and exclusion criteria from the SPRINT and ACCORD trials, respectively.^2,3 While both trials excluded individuals with factors likely to limit medication adherence, only SPRINT specified what these factors might include; thus, SPRINT exclusions were applied to both populations.

^aThe 2017 ACC/AHA guideline defines hypertension based on the average of 2 BP readings of 130/80 mm Hg or higher on 2 separate occasions. In NHANES, BP was measured as the mean of 3 measurements obtained at 1-minute intervals during a single medical evaluation.

^bDiabetes was defined by self-reported history or a hemoglobin A_1c as 6.5% or higher (to convert to proportion of total hemoglobin, multiply by 0.01).

^cLife expectancy less than 3 years is estimated based on Lee Index score of 14 or higher because a score of 14 is associated with a median predicted life expectancy of 3.1 years.⁵

^dAnimal fluency test score less than 15. The animal fluency test examines categorical verbal fluency and scores have been shown to discriminate between persons with normal cognitive functioning compared with those with mild cognitive impairment and more severe forms of cognitive impairment, such as Alzheimer disease.⁶